Psychological Explanations of SZ - Family Dysfunction

• The Schizophrenogenic Mother


  Fromm- Reichmann proposed a psychodynamic explanation based on accounts from patient's childhood.

  many mentioned a specific type of parent: the schizophrenogenic mother

  'schizophrenogenic' = schizophrenia causing

  mother is cold, rejecting & controlling and creates a family climate of tension + secrecy

  leads to distrust and later develops into paranoid delusions, leading to SZ
• Double Bind Theory


  Bateson et al emphasised the role of communication style within the family

  child - regularly trapped in situations where they worry about doing the wrong thing but receive mixed messages about what this is, they feel unable to comment about how unfair this is or seek clarification.

  when they 'get it wrong' they're punished by withdrawal of love, e.g. a parent complains abut never getting affection from the child but when the child tries to hug them, they complain.

  this makes them feel the world is confusing and dangerous

  results in paranoid delusions and disorganised thinking.

  Bateson said this is 'just a risk factor
• High Expressed Emotion (EE)

  EE - level of emotion, mostly negative, expressed towards SZ patients by their carers.

  includes verbal criticism with occasional violence hostility towards patients, including anger and rejection, emotional over involvement in life of patients, including unnecessary self-sacrifice.

  High EE towards patients makes them feel stressed and is a big factor in relapse.

  this could interact with a genetic vulnerability to cause SZ.
• Strength - Support for Family Dysfunction

  Read et al (2005) meta analysis 46 studies of child abuse and schizophrenia

  Findings:

  69% of female inpatients had history of physical or sexual abuse in childhood.

  For men this was 59%.

  Adults with insecure attachments also more likely to develop SZ(Berry, 2008)

  Counter argument?

  Info on childhoods often recalled retrospectively after person already has SZ, thus memories may be distorted due to SZ - thus reduces validity of research.
• Weakness - Weak Evidence for Family-Based Explanations

  there's evidence to support the link between poor childhood experience and development of SZ in adulthood, however there's little to support the schizophrenogenic mother or double-bind.

  Both these theories are based on clinical observation of patients and early evidence involved assessing the personalities of mothers for 'crazy-making characteristics'

  
  

  Another problem with family dysfunction explanations is they lead to family-blaming. Parents who have already suffered by seeing their child develop SZ will likely have to provide them with lifelong care were further traumatised by being blamed. there are ethical issues and also examples of gender bias as it tends to be the mother blamed.

  Shift in the 1980s from hospital to community care, often involving parental care, may have lead to the decline in schizophrenogenic mothers and double-bind theories.